What to Do After a Self-Harm Relapse: Alternative Coping Strategies & How to Tell Someone

Written by Colter Bloxom, LPC

Colter is a licensed psychotherapist and the owner and founder of Thrive Therapy. He specializes in the treatment of anxiety, OCD, pornography addiction, identity issues, and more.

Self-harm is a lot more common than people may think; reports show that nearly 1 in 5 teens, for example, have harmed themselves intentionally. Although self-harm tends to harm mental health significantly in the long run, it can feel like a coping mechanism in moments of distress.

If you've been able to stop self-harming, then that's already an incredible achievement. When you relapse, it can feel discouraging; you may even feel ashamed. But there's nothing to be ashamed of. Continuously walking the road of recovery takes a lot of courage, and you can always make a renewed choice to take care of yourself and keep yourself safe.

What to do if you relapse with self-harm

If you’ve relapsed with self-harm, it’s easy to feel disappointed with yourself. But relapsing isn’t a failure. It may help to think of self-harm like an addiction. Many people with addictions relapse before being able to get “clean” for good. The recovery process is a journey. The important thing now is to take action to prevent it from turning back into a long-lasting habit.

Follow these tips.

Ensure your physical safety

First, get medical attention if you need it. Even if self-harm is non-suicidal behavior, it's entirely possible to seriously hurt yourself. Clean your wounds, and don’t hesitate to call 911 or go to the nearest urgent care/emergency room if you need further medical attention.

Be kind to yourself

It can be easy to judge yourself when you hurt yourself, but try to practice self-compassion. Talk to yourself like you would talk to a close friend going through the same situation. Instead of judging and criticizing yourself, are there any words of kindness you can offer? 

Identify the trigger(s)

Try to identify what triggered you to relapse. This can be an important part of avoiding self-harm in the future. For example, have you been under a lot of stress lately? Did a big change recently happen in your life, like a breakup? When you know what triggered you to start self-harming again, you can make a plan to avoid — or manage — those triggers.

Tell someone

It’s important to let a trusted person know that you’ve engaged in self-harm again. This could be a loved one or a mental health professional, like your therapist. Some people feel afraid to tell others; they fear loved ones will be disappointed. But the people who love you only want to support you. And it’s difficult to get through something like this alone. Talk to someone, and let them know what's going on.

Make a safety plan

Lastly, make a self-harm relapse prevention plan to help you avoid relapsing in the future. It’s essential to avoid all-or-nothing thinking. Just because you’ve relapsed doesn’t mean that you can’t get back on the road to recovery now. Think about what you need to get back on track and continue to keep yourself safe. 

For example, you might make a list of people you can call when you’re feeling triggered to self-harm, including sources of professional help. It can also be helpful to come up with alternative coping skills you can use instead of self-harm. For example, you might put your hands in ice water, listen to music, or get out of the house. 

How to tell someone you relapsed with self-harm

One of the most important steps you can take when this happens is to reach out to someone you trust. It’s common to feel embarrassed or ashamed about relapsing, but there’s nothing to be ashamed of. Anyone can be affected by self-harm. It doesn’t mean you’re weak, and the people you trust want to help.

First, identify who you feel like you can trust. This should be someone in your life who will not judge you or make you feel shamed for self-harming. But it should also be someone who you can trust not to enable you or encourage self-harming behaviors.

Be honest, and don’t beat around the bush. If this person knew previously about your self-harm, then let them know that you’ve relapsed. Talk to them about what triggered it, and how you’re feeling now.  

If the person seems disappointed, sad, or frightened, try not to take their reaction personally. It can be a shock to learn that someone you love is hurting themselves, but that doesn’t mean they’re judging you. 

Be specific with the person about how they can support you. It may be helpful to reflect on how this person can best support you before you tell them. Let them know whether you just need them to listen, or if you’re ready for them to help you.

Your loved one may have questions about what your self-harm means, and whether you’re feeling suicidal. Be honest with them so that they can support you and keep you safe.

Asking for help when you’ve relapsed is brave, and it can be scary. But it’s a gift you can offer to yourself: a reminder that you don’t need to go through this alone.

Recognizing the warning signs of a self-harm relapse

It can be helpful to recognize the early warning signs that a self-harm relapse might be coming. When you notice these signs, you know that you’re more vulnerable and likely to self-harm, so you can take steps to protect yourself.

The signs of a self-harm relapse depend on each unique individual. Try to notice the physical and emotional changes that you experience which let you know that you might be more vulnerable to self-harming.

Some common warning signs that a self-harm relapse could be coming include: 

• Increased emotional distress – Feeling overwhelmed, hopeless, or emotionally numb can be a red flag. You might notice that small stressors feel harder to manage, or that your usual coping skills aren’t working as well as they used to.
  
  
• Urges creeping back in – Maybe thoughts about self-harm start resurfacing, or you find yourself reminiscing about past self-harm behaviors. You might not act on the urge right away, but the fact that it’s there could mean that you’re at risk.
  
  
• Feeling disconnected or dissociated – If you’re zoning out more than usual, struggling to stay present, or feeling detached from reality, it might be a sign that your mind is trying to escape overwhelming emotions.
  
  
• Avoiding support systems – Pulling away from friends, therapy, or other sources of support can sometimes be another sign. You might feel like no one understands or like you don’t want to burden others.
  
  
• Returning to old patterns – You may find yourself engaging in behaviors that you used to do before self-harming in the past — like isolating yourself, taking out objects you used to self-harm, or revisiting places or objects tied to past self-harm.
  
  
• Intrusive thoughts – If you’re having more thoughts about self-harm, or even just general thoughts about punishing yourself, it could be a sign that your mental health is declining and that you need extra support.
  
  

But know that even if you missed the signs this time, it’s never too late to prevent a self-harm relapse from getting worse. You can always stop yourself from continuing. Maybe before, it took you years to stop self-harming, and this time you catch yourself within days and are able to stop. That’s a huge achievement. 

Even if you missed the signs before relapse happened, try not to fall into the trap of all-or-nothing thinking. You can still take steps now to keep yourself safe and protect your mental health. This doesn’t need to turn into a spiral.

Recovery from self-harm with our Mental Health IOP

If self-harm has become overwhelming, or if once-a-week therapy isn’t enough, Thrive Therapy’s Mental Health Intensive Outpatient Program (IOP) can offer the structured support you need. 

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Unlike most IOPs, which primarily focus on addiction, ours is designed specifically for mental health concerns—including self-harm, depression, and trauma. Our program meets multiple times per week, and provides evidence-based therapy, group support, and personalized treatment plans to help you build healthier coping strategies.

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